BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AUTOSOFT XC

    MDR report key: 19493539 · Received June 8, 2024

    Report

    Report Number
    3003442380-2024-07127
    Event Type
    Malfunction
    Date Received
    June 8, 2024
    Date of Event
    April 19, 2024
    Report Date
    June 7, 2024
    Manufacturer
    UNOMEDICAL A/S
    Product Code
    FPA
    UDI-DI
    05705244021099
    PMA / PMN Number
    K032854
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    INITIAL AND FINAL MDR 1882091 - MDR 3003442380-2024-07127 - DEVICE 3 OF 4.

    Description of Event or Problem · 0

    UNOMEDICAL REFERENCE NUMBER (B)(4). EVENT OCCURRED IN THE UNITED STATES. IT WAS REPORTED THAT THE PATIENT FACED SIMILAR EVENTS OF BENT CANNULA WITH FOUR INFUSION SETS. THE SYMPTOMS WERE NOTICED WITHIN 3 HOURS OF INSERTION. THE SITE OF INSERTION WAS ABDOMEN AND WAS ROTATED REGULARLY. PATIENT'S BLOOD GLUCOSE AT THE TIME OF EVENT WAS 302 MG/DL. THEREFORE, PATIENT REPLACED INFUSION SET AND RESUMED INSULIN DELIVERIES SUCCESSFULLY. UNOMEDICAL DO NOT SEE BENT/KINKING AS BEING RELATED TO HUMAN FACTORS, BUT RATHER AS A TRAINING ISSUE INCLUDING CORRECT CHOICES OF INSERTION SITES AND INFUSION SETS AND CANNULA LENGTH. FURTHERMORE, THE SOFT CANNULA IS A FLEXIBLE MATERIAL THAT DURING USE AND UPON REMOVAL CAN BEND SLIGHTLY. NO FURTHER INFORMATION AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1264689 AUTOSOFT XC UNO INSET I 80/6 GREY TCAP 10PACK US FPA UNOMEDICAL A/S 1003912 6004706 05705244021099

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Male